Written by Karolyn Moore and edited by Tommaso Filippini
Menstruation remains a sensitive issue within the European Union (EU), sparking discomfort and stigma that transcends ages and spaces, from childhood to the workplace. The discussion on menstrual health has evolved, integrating discussions beyond reproductive functions into educational curricula, workplace policies, and societal dialogues. Within the EU, the divergence between Spain’s and Hungary’s approaches shows the spectrum of menstrual health policies. While both nations address taboos, their strategies differ widely in terms of governmental engagement and societal initiatives.
Hungary, under the Fidesz party, grapples with policies diverging from EU standards, emphasising parental responsibility in sexual education, which leaves gaps in structured menstrual health education. Civil society initiatives like the Lányból Nővé and the Nemluxustáska campaign fill this void, however, they depend predominantly on private funding due to governmental limitations, particularly affecting rural areas.
Spain showcases a more proactive stance on menstrual health, by empowering regions to expand menstrual health education beyond biological functions. Legal reforms, including Catalonia’s provision of free menstrual products and the nationwide introduction of paid menstrual leave, highlights Spain’s progressive strides within the EU.
The dichotomy between Hungary’s and Spain’s approaches underscores the pivotal role of governmental policies and societal responses in combating Period Poverty. Spain’s multifaceted model, emphasising progressive policies and inclusivity, serves as an example, highlighting how critical these approaches are in encouraging societal well-being and therefore achieving gender equity.
Menstruation is a taboo topic across the world. At the very least, every person who menstruates has a story about a time when they were made uncomfortable when a peer, family member, or stranger was simply made aware that they were on their period. These taboos often extend beyond childhood and adolescence, through school, and often enter into the workplace. In recent years, the global conversation surrounding menstrual health has gained momentum, revealing and changing the policies and practices implemented in different countries and regions of the world. The significance of menstrual health has grown beyond a function of the reproductive system, as it is now integrated and discussed in education, workplace policies, and society. The approaches to menstrual health policies differ within the EU, especially between Spain and Hungary: focusing on educational initiatives within schools, to also include distribution of products, the involvement of non-governmental organisations (NGOs) and local organisations to educate and provide resources to young adults, and the laws (or lack thereof) governing menstrual health in workplace settings. Without better menstrual education, low-cost or free access to menstrual hygiene products, and more equitable workplace standards, the landscape is uneven, and gender equality will not be reached.
Menstrual Hygiene Management
Menstrual Hygiene Management (MHM) and Menstrual Health and Hygiene (MHH) both refer to the practices and facilities needed for people who menstruate to manage their menstruation in a healthy and dignified manner. Although access to menstrual products is a large component of this, sanitation facilities, education about menstrual hygiene in the form of sexual education, and supportive societal attitudes that break taboos surrounding menstruation are essential components, which is why the term Period Poverty is also gaining momentum. Lack of education about menstruation can result in misconceptions and inadequate understanding of menstrual hygiene practices. This can lead to improper hygiene management during periods, increasing the risk of infections and health complications. When people who menstruate are not educated about periods, they may feel ashamed or embarrassed about a natural bodily function. This lack of understanding contributes to the perpetuation of stigma surrounding menstruation, impacting personal self-esteem and mental well-being. People who menstruate might miss school during their periods due to discomfort, embarrassment, or inadequate sanitary facilities. According to the world bank, an estimated “500 million lack access to menstrual products and adequate facilities for MHM” (The World Bank, 2022). This absence can impact their academic performance and result in missed educational opportunities, perpetuating gender disparities in education. These problems extend beyond children and young adults in schools to also include women in the workplace. As the discipline of MHM is developing and quite holistic, simply distributing pads and other menstrual materials to girls is no longer the best solution.
In 2021, the European Parliament’s Resolution on the situation of sexual and reproductive health and rights in the EU called for:
“Member States to ensure comprehensive and scientifically accurate education about menstruation, to raise awareness and to launch major information campaigns on endometriosis targeting the public, healthcare professionals and legislators; calls on the Member States to ensure access to period education programmes for all children, so that menstruators can make informed choices about their periods and bodies; calls on the Member States to urgently tackle menstrual poverty by ensuring that free period products are available to anyone who needs them.” (Texts Adopted – Sexual and Reproductive Health and Rights in the EU, in the Frame of Women’s Health – Thursday, 24 June 2021, n.d.)
Menstrual Leave in the Workplace
Menstrual leave in the workplace is crucial as it acknowledges that people who menstruate may face unique challenges due to pain caused by menstruation, as well as other syndromes such as endometriosis, Polycystic Ovary Syndrome (PCOS), and dysmenorrhea, extreme pain while menstruating. When employees are struggling with menstrual symptoms, their productivity and performance at work can be affected. Allowing time off could improve overall productivity by ensuring that employees are able to rest and recuperate, allowing them to return to work more focused and effective. Normalising menstrual leave also helps to reduce the stigma surrounding menstruation. It encourages open conversations about reproductive health in the workplace and contributes to a more supportive environment.
Naturally, there can also be problems if menstrual leave is incorporated in an improper manner. Menstrual leave policies might inadvertently lead to biases during hiring processes or promotions, as some might assume that individuals who menstruate are less reliable or committed to their work. Others argue that introducing menstrual leave policies could inadvertently lead to stigmatisation as some employees might feel uncomfortable taking leave due to concerns about privacy or judgement from colleagues or supervisors. Perhaps most challenging is ensuring fair and equal treatment for all employees, regardless of gender identity.
Spain is the first country in the EU to offer menstrual leave, however many countries in other parts of the world have implemented it for years. The Soviet Union was the first country to offer paid menstrual leave in 1922, followed by Japan in 1947; however, women in Japan have statistically utilised the leave infrequently (Huet, 2022).
The Hungarian government, led by the right-wing populist party Fidesz-Hungarian Civic Alliance, has received criticism for its often peripheral policies which diverge from the EU standards and values.
Fidesz’s view on sexual education in schools does not stray from this. In 2020 UNICEF Hungary co-conducted a study with Publicus Intézet regarding sex ed, with 55% of respondents believing that students do not receive a comprehensive sexual education in schools (UNICEF, 2020).
In 2021, the Hungarian Child Protection Act was passed which declared that sexual education should be taught by parents rather than at school, and any information presented in school must only be complementary and still approved by parents (Orbán, n.d.). This only further limited the information available to young adults. Átlátszó Oktatás, an investigative journalism nonprofit ran a study in 2022 which found that of the respondents of their study, “3.5% had heard about sexuality for the first time in a school class, most of them (81.2%) having got their information from friends, the internet or television… with only 15.3% of respondents saying that their parents had informed them” (Missing Knowledge, Non-existent Registration – Sex Education in the Shadow of the New Hungarian Child Protection Act, 2022). Although there are no specific statistics on menstrual health education, these lessons are typically a part of common sexual curricula.
On Menstrual Hygiene Day 2023, the WHO Europe office “called on countries to provide adequate water and sanitation services in schools, including better menstrual hygiene facilities and menstrual health education. These are crucial school interventions that are fundamental to health, well-being and dignity, as well as ensuring gender equity and equal learning opportunities” (World Health Organization: WHO, 2023). The 2023 Ministerial Conference on Environment and Health was held in Budapest, however, the Hungarian government took no steps to create a commitment to menstrual education and eliminating Period Poverty.
Access to menstrual supplies such as pads and tampons is cost-prohibitive for people who menstruate and it is an unavoidable cost. The Tampon Tax is 27% in Hungary, the highest in Europe (Buchholz, 2020). Where the government fails, civil society steps up to the plate to aid women and girls through private programs.
The Hungarian Red Cross launched the Lányból Nővé (From Girl to Woman) program, supported by Procter & Gamble. The program was active in the state schools of two districts in rural Hungary; 1600 students were reached, girls received six months worth of pads, and educational classes were held, separated by gender and age (Lányból Nővé Program Egy Egészséges És Felvilágosult Generációért, 2018). In the Budapest area, the Lányból Nővé program distributed almost 37,000 pads to 12,000 girls (Lányból Nővé Program Egy Egészséges És Felvilágosult Generációért, 2018).
Nemluxustáska, translated to Not A Luxury Bag, is a nationwide campaign in which people fill gently used bags with personal care products, including but not limited to menstrual care products, which are distributed around the country. It is important to note that tampons and menstrual cups are not accepted. In 2020, approximately 17,000 bags were collected and donated (Nemluxustaska | Nem Luxus Táska – Kampány a Nők Támogatásáért, n.d.). Tampons and menstrual cups require people who menstruate to have adequate hygiene facilities, and therefore may not be appropriate for some.Moreover, Hungary does not have any menstrual leave laws in place.
The official educational curriculum in Spain acknowledges menstruation’s role in reproduction but doesn’t cover menstrual health. In Spain, each autonomous region and city maintains their education curricula, and therefore regional authorities have the ability to instruct on menstrual health beyond reproduction. Consequently, menstrual education content can vary between regions. Some regional regulations do not explicitly address menstrual health but refer to sexual education and hygiene, which could encompass menstrual health (Lopez et al., 2023). Family members are expected to teach young adults about details which are not covered in the school curriculum. A recent study approved by the Research Ethics Committee of the Polytechnic University of Valencia found that when respondents were asked about their first period, “35.7% of respondents scored five or less indicating that a significant proportion … did not remember properly understanding why they were bleeding” (Lopez et al., 2023). However, a reform to the Organic Law 2/2010, on sexual and reproductive health and voluntary interruption of pregnancy, contains exciting steps towards reducing Period Poverty.
Article 10 of the Organic Law 2/2010 declares that educators should “approach … menstruation with a gender perspective… special attention to the elimination of myths, prejudices and gender stereotypes that generate menstrual stigma” (BOE-A-2010-3514 Ley Orgánica 2/2010, De 3 De Marzo, De Salud Sexual Y Reproductiva Y De La Interrupción Voluntaria Del Embarazo., 2023). The law also requires educational institutions to provide free menstrual products and encourages the distribution of products which are sustainable and free of chemicals (BOE-A-2010-3514 Ley Orgánica 2/2010, De 3 De Marzo, De Salud Sexual Y Reproductiva Y De La Interrupción Voluntaria Del Embarazo., 2023). The region of Catalonia took these measures a step further, announcing that beginning in 2024, menstrual cups, pads, and period panties will be available for free from pharmacies (Reuters, 2023).
In February 2023, Spain also became the first EU country to pass a menstrual health leave policy. Women can take three paid days off a month, with the option to extend it to five days a month with a note from a medical professional; the government, via the social security system, will pay for the leave (Bello, 2023).
Two Ends of the Spectrum
Hungary and Spain showcase varying approaches to menstrual health education and accessibility to menstrual products. In Hungary, there is a clear discrepancy between governmental involvement and civil initiatives. The government’s stance, reflected in the Hungarian Child Protection Act, emphasises parental responsibility for sexual education and limits school-based information. Studies reveal a lack of comprehensive sex education in schools, leaving many to rely on alternative sources like friends, the internet, or television for information. The government’s inaction in committing to menstrual education or reducing Period Poverty contrasts sharply with civil society’s efforts. Initiatives like the Lányból Nővé program and the Nemluxustáska campaign address the issue by providing education, supplies, and support to young girls, primarily reliant on private initiatives due to governmental shortcomings.
Spain, in contrast, exhibits a more proactive governmental approach. While the official educational curriculum acknowledges menstruation in the context of reproduction, regional authorities have the autonomy to expand educational content on menstrual health. Reforms to laws and regional initiatives emphasise a gender-sensitive approach to menstrual education, aiming to eliminate stigma and myths. Catalonia’s announcement to provide free menstrual products from pharmacies, including menstrual cups and period panties, and the nationwide policy granting paid menstrual leave demonstrate Spain’s progressive strides in menstrual health initiatives.
Spain displays a more comprehensive approach compared to Hungary, combining legal reforms, regional initiatives, and policies aimed at eliminating stigma, ensuring accessibility to products, and providing paid menstrual leave, setting a precedent within the European Union.
In the landscape of menstrual health policies and practices Hungary and Spain show the spectrum of approaches within the EU. While both states grapple with taboos and challenges surrounding menstruation, their strategies significantly differ, showing varying degrees of governmental involvement and societal responses.
Hungary, led by the Fidesz party, grapples with policies that steer away from EU standards and values. The absence of structured education concerning menstruation and reproductive health leaves a void, compelling young individuals to seek information from unofficial sources, which may perpetuate misconceptions and gaps in knowledge. The government’s lack of commitment to menstrual education or tackling Period Poverty contrasts starkly with the initiatives of civil society. Programs like the Lányból Nővé and the Nemluxustáska campaign address the gaps, offering education, supplies, and support to young girls, yet predominantly reliant on private initiatives due to governmental limitations. With limited funding, there will be limited outcomes, especially with the ability to reach young women in rural areas.
Spain presents a more proactive approach compared to Hungary. While the official curriculum acknowledges the role of menstruation in reproduction, regional authorities possess the flexibility to expand educational content on menstrual health. Reforms within laws and regional initiatives adopt a gender-sensitive lens, aiming to dismantle stigma and misconceptions surrounding menstruation. Catalonia’s innovative decision to provide free menstrual products in pharmacies and the nationwide implementation of paid menstrual leave represents strides in menstrual health initiatives within the EU.
The differences between Hungary’s and Spain’s approach to menstrual health serves as an example of the roles of both governments and civil societies in mitigating Period Poverty. As the discourse on menstrual health continues to evolve, Spain’s model stands as an example, both in and outside of the EU, emphasising the significance of progressive policies and education in attaining gender equality.
Bello, C. (2023, February 25). Painful periods? Spain just passed Europe’s first paid “menstrual leave” law. Euronews. https://www.euronews.com/next/2023/02/16/spain-set-to-become-the-first-european-country-to-introduce-a-3-day-menstrual-leave-for-wo#:~:text=The%20law%20gives%20the%20right,system%20will%20foot%20the%20bill.
BOE-A-2010-3514 Ley Orgánica 2/2010, de 3 de marzo, de salud sexual y reproductiva y de la interrupción voluntaria del embarazo. (2023). https://www.boe.es/buscar/act.php?id=BOE-A-2010-3514
Buchholz, K. (2020, May 28). Where the “Tampon Tax” is Highest and Lowest in Europe. Statista Daily Data. https://www.statista.com/chart/18192/sales-tax-rates-on-feminine-hygiene-products-in-europe/
Huet, N. (2022, May 23). Spain’s menstrual leave: The countries that have already tried and tested days off for period pain. Euronews. https://www.euronews.com/next/2022/05/13/spain-s-menstrual-leave-the-countries-that-have-already-tried-and-tested-days-off-for-peri
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